Cardiac case
A cardiac case 79 yrs old male , got bypass surgery done in 2004-2005 around , had surgery for cholelithiasis around few yrs back . Taking telmisartan 40 Omeprazole 40 + domperidone , arorvastatin 40 , aspirin , ativan( lorazepam) 2 mg , Now having tingling sensation at the tips of fingers and legs , pain in the rib of right ide of chest on bending or while pressing at that point. Agitation , numbness in the right hand ( as per him due to (pet )dog bite 2-3 yrs back taken arv as per schedule , a bit of low feelings. He has been taking ativan 2mg daily since the surgery as the doctor here told him that it’s necessary for him to take that medicine, without medicine he can’t sleep. His bp is around 130/80 , spo2 94- 97% RA, nausea feeling , fatigue and don’t want to do any work are the complaints. I suspect the long term use of lorazepam as the culprit, if its so please suggest the alternative method of treatment in this case sir. If not what would b the probable cause sir ??
Anxiety/Depression is quite common in cardiac cases whether stenting or CABG Would have been better if SSRI + Bzds was there to tackle sleep/anxiety/Depression Meanwhile, you can put him on Ativan 1mg for 2 weeks and then completely stop it, also start cap Becadexamin once daily in morning and tab calcimax forte at night Also get his Vit B12, D3
Anxiety/Depression is quite common in cardiac cases whether stenting or CABG Would have been better if SSRI + Bzds was there to tackle sleep/anxiety/Depression Meanwhile, you can put him on Ativan 1mg for 2 weeks and then completely stop it, also start cap Becadexamin once daily in morning and tab calcimax forte at night Also get his Vit B12, D3
Rx HRT 2bd Arjunarostha 20ml bd Galo ghan 1 tab bd
Anxiety neurosís B12 deficiency
Rx Multivitamins, psychiatric consultation
? Anxiety.. ? Drug induced...
Tingling sensation may be d/t vit B12 deficiency or any neuropathy.in place of lorazepam you can use cloze .25 mg
B12 deficiency, Anxiety and Depression are reasons behind such sensations... Can change to newer safer sleep medicines after consultation with Psychiatrist
? ANXIETY NEUROSIS.. ? DRUG DEPENDENCE .. NEED'S.. PSYCHIATRISTS OPINION.. PLACEBOS.. MULTIVITAMINS ANTIOXIDANTS..
Cases that would interest you
- Login to View the image
Post covid-19 complications are being seen these days in community *Chief Complaints* Rashes, burning foot, restlessness, small papules with abscess
Dr. Dharm Raj Mehra1 Like23 Answers - Login to View the image
7 yr girl with habit of tongue rolling around lips now with this types of lesions, No itching please suggest treatment. No effect with fluticasone +mupirocine ointment after 15 days
Dr. Neki Yadav4 Likes22 Answers - Login to View the image
A 41 yo male patient with chronic fatigue syndrome and nervousness, irritability; sometimes he feels muscle weakness and hand tremor for three months and getting severe in ten days. Wants to check up his liver and nervous system. Abdominal ultrasound revealed nothing abnormal.
Dr. Satyendra Kaur2 Likes12 Answers - Login to View the image
42 female c/o left sided chest pain for last 3 weeks AT THE TIME OF onset of pain 3 weeks ago ...patient also complained of pain and numbness in left leg which is now absent. ECG-WNL ECHO-WNL chest-ckear cvs-NAD no tenderness no fever was on diclofenac+metaxalone tizanidine amitryptilline 10 pan 40 but of no relief pain decrease to some extent at some time...again intensity increases kindly give your valuable opinion on how to proceed.
Dr. Ankan Sengupta2 Likes11 Answers - Login to View the image
Wishing all Respected CUROFIAN STALWARTS their loved ones Very Healthy Happy FATABULOUS Prosperous BAISAKI BIHU VISHU. ************************************************** Let's have a review of a Superb HOMOEOPATHIC Remedy Argentum Nitricum-Silver Nitrate'-proved By Dr.Hahnemann on himself...!! SYCO-SYPH MIASM The best remedy for ANXIETY NEUROSIS APPREHENSIVE ANXIETY Anemia Panic Attacks Chancre Dyspepsia Epilepsy IBS GASTRITIS Eructations Waterbrash,GERD GTCS A great eye remedy-sure opthalmia NEONATORUM dacryocystitis FEAR FRIGHT Gastric Ulcer,Hemicrania Herpes Labialis Genitalis Zoster Chicken Pox Cheiropompholyx Exfoliative Dermatitis IMPETIGO CONTAGIOSUM, Body-mind Incordination Locomotor Ataxia Bedwetting Urinary incontinence Trig Neura.Bells Palsy, Paraplegia BPH Syphilis ALTERED TASTE IN PARANOIA APTHAE Trembling Tremors Chorea Stammering FISSURED TONGUE WARTS I've used for leucoplakia...80 yr old man his case is there on record...having SMF..Asked me $aheb mane cancel to nai thai tears rolled....out....Thodu gol apsho...moh sukai CHEY.. Arg-Nit 200 Another live case..my father a typical LYCO acute Dioscorea Developed fever... He told me RAJA.. put sugar in water..with a nice sweet smile but sweat on forehead..checked vitals...ok..(Don't tell doctor or in the house...they will think I am mad..).I could read the anxiety on his face Arg-Nit.200 Lowered the fever his anxiety His craving for sugared water nor fever never returned....and he lived till 86. One small kid 5 yrs old would refuse to go to school...encopresis BMG will soil herself the moment you raise your voice or hand...(Here IUGS is important mother faced mental torture from MIL for dowry all would beat her and would lock her up for hours...supp .nature..calls.fear of closed places crowd New places...all this started) Arg-nit..200-1m cured the child ! ..This is the beauty of HOMOEOPATHY **When I ask CUROFIANS for history they call/ write abusive mails LACED with the best known expletives used in their families One guy has even threatened me with dire consequences ...Cant help it...It is a manifestation of their Supressed Debaucherous KHANDANI Syco-Syph Miasm thats throwing up!! *Roses & Brickbatts Welcome!! Once again I wish you all a HAPPY NEW YEAR...tc. ☆♡☆♡☆♡☆♡☆♡☆♡☆♡☆♡☆♡☆♡☆♡
Dr. Rajan N. Iyer3 Likes9 Answers
4 Likes